It's six o'clock in the evening and the models waiting in the ballroom of the Virginia Commonwealth University student commons are looking a little tired. They've been rehearsing the same 160 or so steps down the same runway for a while now, over and over, and the pain inflicted by high heels is starting to show. Downstairs, fellow students are lounging around or standing in line for the kind of fast food fare that makes just about any student union in the country indistinguishable from any other—Chik-Fil-A, pizza, Subway.

But up on the second floor in the Commonwealth Room, it's all business. Graphic arts majors fiddle with a complex animation sequence of the letters that make up the word "Muse" on two big screens, lighting technicians adjust spots, and the student models practice their best looks, that fleeting second when they've reached the catwalk's end and toss a flirty glare to the audience. Without any actual garments to wear—those won't arrive until the next morning—just about the only thing that is truly polished at this point, exactly twenty-four hours before show time, is the soundtrack. And so as model after model makes her way down the runway, the insidiously dreamy sounds of the L.A. duo The Bird and The Bee fill the ballroom with the kind of electro pop you could easily imagine playing in the background at any of the New York fall shows.

Give it up for me please
put your hands in the air
if you know what's good for you
you wanna shake it like you just don't care.

Among the 475 empty chairs, a woman sits with her head resting on the stage at the bitter end of the runway. A bit younger than the other professors who have come to steal a sneak peek of tomorrow's annual juried fashion show, she looks as though she might be taking a quick nap. But the truth is that Lindsay Aronson Ess knows this drill so well by now that exerting any energy to lift her head seems a waste of time. As teacher of the full semester class in fashion show production, there's not much more that she can do now. And so Lindsay just rests her head on the end of the runway, singing along to each song as it plays.

Would you please clap your hands
now get up on your feet
I beg of you to get up and dance
it's such a crazy kick ass beat.

Lindsay, it should be noted, has no hands to clap and no feet on which to get up. She had them back in the summer of 2007, when she was tall and thin and had just graduated from VCU with a fashion merchandising degree. Then, to use her words, a blur. When she entered Henrico Doctors' Hospital that summer, the procedure to remove a small piece of inflamed intestine, a nagging complication of her Crohn's disease, was supposed to go routinely. But supposed to go routinely rarely turns out well, and there hasn't been a routine day in Lindsay's life ever since. Not since the leak, not since the sepsis, not since the organ failures, the brain seizures, and not since the coma. Definitely not the coma. Not since one day in August turned to October and then drifted on towards Christmas. Certainly not since the quadruple amputations, the cruel coda to having been so close to death all those months and then surviving. Oh, honey, you know what they're going to do, right? the nurse said. There's no routine to being bathed and fed and dressed like a child mere months after you've graduated college, and no routine to learning how to walk again at the age of twenty-five. No routine in continuing a long-distance relationship with someone who admits to having originally been smitten by your looks, or to being with your mother almost every waking hour. There's no routine for taking a fistful of pills a day—the Pentasa, the Entocort EC, the Lexapro, the Keppra, the Urosidol, the Spiranolactone, the Zolpidem, the Lyrica, not to mention the occasional shot of actual alcohol. There's no routine, no manual, for wishing you were whole again, so that just one morning of your life you could actually wake up and make it to the bathroom on your own, even if the arms and legs you now covet so are made of acrylic and not skin and bone and muscle. And, perhaps most of all, no routine for the long, slow realization that those acrylic arms and legs might not, in the end, be the answer to anything. If you're Lindsay Ess, routine pretty much stopped on August 3, 2007.

But here tonight at this dress rehearsal, the only thing that is routine is fashion show production and Lindsay is clearly in her element. The young woman who so desperately wanted to be in the business of body image now owns the whole store. Lessons that might have been clinical lectures on price point and merchandise are now peppered with words like faith and belief and wrapped up in parables about the joys of water skiing. I see things differently now, she'll say. A leaf. A flower. Everything. And so it's no surprise to see her finally lift her head off that cozy perch at the end of the runway and yell something over the booming beat.

"Sex it up, ladies! Sexier! And Shera—no more tanning."

***

It's a spring day in Richmond a year earlier and the small house Judith Aronson shares with her daughter Lindsay is quiet, except for Matt Lauer droning on to no one in particular from a television located by the front door. Above the set, next to a framed series of classic Frank Sinatra album covers—In the Wee Small Hours, Swing Easy!—a single sheet of paper is taped to the wall. There's a photograph scanned on the paper, a beautiful young woman with long hair, laughing brightly. Next to the photo, one simple sentence: "Lindsay Lu will be good as new!!" Placed strategically, so that everyone who enters or leaves is required to look at it again and again, the note is clearly less prayer and more declaration of intent. Not please make Lindsay Lu as good as new. Lindsay Lu will be good as new.

Into this brightly-colored living room comes Judith, carrying her only daughter. She makes two gentle deposits: Lindsay into a big recliner, followed shortly thereafter by a mound of pills onto an adjacent tray. Judith leaves again to get herself dressed and Lindsay is kept company by the family dog, Sadie, whose main mission in life seems to be always snoring at someone's feet. It's hard not to stare a bit at Lindsay, no matter how often you're with her, but it's the story of her life really; once, during college, stared at for her beauty; then, later, stared at in the gym after the obsessive exercise regimen took hold; and now, on this spring day in Richmond, stared at in her current state, sitting on a recliner wearing a pair of flannel boxer shorts and a white-t-shirt and missing her arms below the elbow and her legs below the knee. Her hair is short—gone is the long hair in the photograph by the door—and what remains of her right leg is in a cast, a two-inch hole at her kneecap exposing a nasty open wound that goes straight to the bone. Around her throat, a large rainbow colored Band-Aid covers the remains of a distant tracheostomy. But as Judith likes to say, Lindsay's still Lindsay, and her particular brand of analysis, an endearing style of malapropism buried within declarative statement, not to mention a smile that always seems to force itself, even during terrible pain, to the surface, has a way of putting people at ease. "Mom, what are those stages again?" she yells into the other room. The question hovers a minute.

"What stages, Lin?"

"You know, those stages of grief," says Lindsay, who is called Lu by good friends. She pauses to watch something on the television and then continues. "I read somewhere on the Internet about these nine stages of grief. And I thought to myself, 'I didn't have any of those,'" stopping once again to comment on a baseball score. "But the more I thought about it, the more I realized I had all of them. Just not in the right order."

Photo by Matt Mendelsohn

I've known Lindsay for exactly 10 minutes and it's the very first thing I scribble. A few months earlier, a make-up artist I frequently bump into at weddings—I'm a photographer—asked me for a favor, to say a prayer for a young woman I'd never met. That simple request has led me here, into this yellow living room in Richmond's West End, watching Lindsay wait for her mother to dispense all those pills. Well, to be truthful, that simple request for a prayer and the fact that my weekends are sometimes filled with brides and grooms who complain about important things like the size of shrimp and missed hair appointments, something which in turn usually causes my make-up artist friend Kim to stop applying lipstick, peer out over her glasses, and, thinking of Lindsay, shoot me a look across the room that says they have no freaking idea. After months of these looks, I feel duty-bound to come to Richmond and seek out this Lindsay, the woman who thought she would be out of the hospital after her August surgery in, well, August. What went wrong? Who was to blame? How does one cope? These are the things that race through your brain when you hear a story like hers but it becomes quickly apparent that Lindsay operates on her own schedule.

Just not in the right order. At 26, it's not surprising that Lindsay might not have the famous Elisabeth Kübler-Ross model of loss and grief down pat. Published in 1969, fifteen years before she was even born, "On Death and Dying" is not exactly a book one reaches for before it comes in handy. For the record, it lays out only five stages, not nine: Denial, Anger, Bargaining, Depression and Acceptance, generally in that particular order, though the notion of having them in the wrong order seems far more interesting. (After all, "Let's just get on with it," what Lindsay finally blurted out to the doctors before all four of her limbs were amputated, doesn't exactly qualify as a Denial.) But on this particular morning, as Judith alternates between helping to wipe down the sores around her daughter's four residual limbs and being a catch-all for a host of complaints—"I don't want to wear your shoes. They look so....old" and "the last four toes (of her prosthetic leg) look like one toe. Hello? I'd like to have normal toes"—you quickly realize that the name of one of those extra stages Lindsay added into the Kübler-Ross mix might as well be called Mother.

They are a pair, Lindsay and Judith, and in this case the word pair takes on a depth untested by normal bounds of contentious and comic mother-daughter relationships. "She was the sweetest, most endearing child," Judith says. "Everybody fell in love with her."

The second of two children—her brother Mehs, named for his grandfather, is eighteen months older—Lindsay Ess was born March 29, 1983. A year later, her father, Michael Ess, a jazz musician, left. Judith, who was working in the food business, selling choice cuts of meat to restaurants and hotels, moved Lindsay and Mehs north to Alexandria, Virginia and, seven years after that, to San Antonio, so the kids could be closer to their grandparents. After fulfilling a promise that they stay in Texas until after high school graduation, the family of three moved back to Richmond for good in 2000.

"I had the best mother in the world," Judith will say later. "A mother sacrifices everything for her child. That's just the way it is. It's your child. I don't know any other way of being."

A mother's love aside, today, Judith needs to help her daughter get ready today for occupational therapy and all the volleyball camps and tennis lessons in the world can't prepare you for Belts 101. Lindsay graduated with a fashion degree, after all, and I quickly sense that fashion majors aren't keen on being dressed by their moms. To watch them go back and forth over the most minute of details—the length of her pants, the position of her belt, the best way to clip her hair, even the best route to take to the therapist—can be an excruciating experience. After a while, there has to be some boiling point for Judith, who complies with each ensuing request, but it never comes. Eventually, she'll simply tell me, "She can't be the one driving," distilling the complicated issue into six simple words. But for now, Lindsay just stares into the mirror.

Despite the ever-present banter, it's clear Lindsay understands more than she lets on. "I desperately want to have kids, just so they can carry on," she says. "There need to be more people like me and my mom and her family. She has been my rock." (Then, as she briefly mulls the possibility of adoption, she adds, in her Lindsay way, "I'm not going to be like what's her name? I can't stand her. Jolie?? I'm going to stay in the States. I'm not going to go to every little teeny cottage in the middle of Saudi Arabia, or wherever she goes.")

The belt finally adjusted, it's off they go, Lindsay in a wheelchair, wearing one prosthetic leg and clutching the other between her elbows; past the copy of the Richmond Times-Dispatch on the coffee table, the one with Lindsay on the front page, past snoring Sadie, past the fridge with the magazine advertisement of a beautiful athlete with a high-tech prosthetic leg hawking an SUV taped to it, and into a ritual they'll repeat countless times: Judith maneuvers Lindsay's wheelchair next to her 1998 Mazda 626, opens the front passenger door, and in one motion lifts her grown daughter into the front seat. They perform this move so often, so many times a day that you stop paying attention very quickly. But because it's still fresh, and because pictures are what I do, I take a photograph.

A half an hour later, in one corner of a large carpeted room, Judith, her glasses riding low on her nose, is sitting on a bench with her arms spread wide open. It's an odd sight, given that no one is actually close to her. Across the room, three therapists flank Lindsay like NASA technicians readying a shuttle astronaut. It's only the second time she has walked since her quadruple amputations and the going is slow and deliberate, each step an odd combination of jerky lurches mixed with a dash of tightrope walker's grace. (Our legs are the key to walking but it's our arms, like that long pole, which provide the balance.) And though she won't arrive in her mother's corner for another minute or two, there is Judith, arms outstretched and at the ready. The look on her face is a mixture of pride and hope, but mostly, it seems, plain old unconditional love.

When I get home, I go back and look at the photograph I took of Judith about to lift Lindsay into the car earlier in the day and I'm reminded what struck me then: frozen in a 1/160th of a second, Lindsay is looking up at her mother with all of those same qualities.

Acceptance

Photo by Matt Mendelsohn

All fashion begins with a dress form, the ground zero of couture, and Room 401 in VCU's Pollak Building, home to the fashion merchandising department, is teeming with them. They line the classroom walls, armless and legless caryatids watching over a centuries-old, symbiotic relationship between the business of fashion and body image. But what today is seen as a production instrument, the dress form as blank slate upon which an Isabel Toledo or Armani builds an empire, is actually a relatively new usage. Dating as far back as Ancient Egypt—King Tut's tomb was said to be stocked with one—and continuing through the Renaissance and up through the Courts of Versailles, the form served an entirely different purpose, something Lindsay Ess grappled with long before her fateful surgery: presentation. Given the absence of any copies of French Vogue lying around the palace, nor, thankfully, any red carpet postmortems from Joan Rivers, monarchs like Marie Antoinette enlisted dress forms in order to dazzle their subjects.

"If you were a royal person and you were getting married, you would be able to put together this incredible trousseau," says Kevin Jones, museum curator of the Fashion Institute of Design and Merchandising in Los Angeles. "And all of these garments were actually put on display on mannequins for the royal court and the public to see. It helped to show how sophisticated you were in fashion, how connected you were, worldly with trade routes, and how rich your kingdom was. So you would show them off."

With the Industrial Revolution, dress forms evolved into the manufacturing role we typically associate them with. But whether presentation mannequin or sewing device, there's one thing that hasn't changed over the years: the dress form has always been sized to the idealized female form, whether we're talking Cleopatatra or Giselle. "An ideal in any era, any generation, is a standout from the average," Jones notes. "The ideal, because not everyone can fit into it. And the people who can accidentally fit into that mold are the people who are admired often."

Lindsay Ess knows all too well about the accidental ones, the ideal, and the warped web of acceptance girls that age get caught up in. "When I was 17, I started to become bulimic," she says. "It all has to do with an obsession with your body. I was so into what I looked like. I was obsessed with what I looked like.

The trouble often begins in the teens. "Eighth grade, ninth grade," she says, talking about the point when girls fall under the spell. "They worry about boys, they worry about what they look like to boys. They worry about little teeny inches of skin—it's not even fat—it's just skin."

And the culprit? "Hilary Duff's skinny," she continues. "Haylie Duff, she's skinny. Paris Hilton. TV, movies. Pictures in a magazine where the girl looks perfect. But that's all Photoshop. Young girls at that age don't understand that it's an industry, they don't understand that's it's business." (Then again, one wonders if young girls understand that the real lunacy surrounding the former Miss California, Carrie Prejean, is not that she answered Perez Hilton's gay marriage question poorly or that she failed to fulfill her contractual obligations, but that pageant officials later admitted to having helped Prejean pay for her breast implants. Or, conversely, that we collectively forward millions of emails about Susan Boyle because we're amazed someone with terrible body image could actually have talent.)

Her late teens defined by the bingeing and purging routine common among those suffering the disorder, Lindsay ran into a roadblock. "I stopped the bulimia when I met my fiancé," she says, referring to Kevin Gipson, a military contractor who specializes in helicopter maintenance in Huntsville, Alabama. "One night we caught each other's eyes at a party, and while passing each other, Kevin grabbed my hand. We held hands while passing until our fingertips couldn't touch. It felt awesome." Gipson agrees. "Lindsay's outward beauty is what initially attracted me to her," he says, "but only after knowing her a few weeks, I was able to uncover what is truly special about this woman: a caring and selfless spirit."

Photo by Matt Mendelsohn

The two have been dating since the spring of 2003 and have now settled into a long-distance relationship. It's not difficult to see some of the physical attraction: Lindsay with her dimpled smile and Kevin, built like Will Smith in some action movie, with his piercing ocean blue eyes. "His worst trait is that sometimes he dresses better than me," Lindsay jokes.

But Gipson's arrival on the scene may have inadvertently brought Lindsay's diet obsession into a new phase, fanatical exercise now taking the place of vomiting. "He was like, 'I don't want to date someone who has problems like that,'" she says, referring to the bulimia. An email much later on smoothes the rough edges around that remark: "He gave me a choice between him and my eating disorder, so I chose him."

And so began the sit-ups. Lots of them. "I would do a million and half sit-ups, I can't even tell you" Lindsay remembers. "Women would like look at me weird. You know, when you see someone that has issues. It was totally obvious."

What Lindsay and Kevin may not have realized at that time is that fanatical exercise is often just another extension for someone suffering from bulimia. According to Lynn Grefe, CEO of the National Eating Disorders Association, "When a person is going through chronicity—when they're so chronic in their eating disorder—it's like wearing a helmet. It takes over all their thoughts. The idea of compensating and obsessing what they ate, and how they're going to get rid of all those calories."

"Her purging and throwing up was disgusting to him," Grefe adds. "But if you look around when you walk into a gym, the idea that she's exercising is wonderful. That's something to be praised. It's an absurd view that we have of what's good and what's evil."

As Lindsay continued to push her limits in her early twenties in pursuit of the perfect body, the exercise and its side effects were masking the march of a more sinister gastrointestinal ailment, Crohn's disease. "There was a long time where the symptoms of Crohn's I sort of just brushed off my shoulder," she says. "I was always hurting in some way, some muscles, somehow." The inflammations and blockages festering inside her intestines were being falsely attributed to those intense workouts.

And there's one more thing, perhaps something only a recovering bulimic might understand. Judith interrupts to remind her daughter that one of the reasons she didn't take her Crohn's medicine regularly was delicately entangled within the competing ailments: You can't take medicine four times a day without also eating four times a day.

"I didn't take the disease seriously," Lindsay admits.

It took her seriously. In May, 2007 she was hospitalized for a blockage in her intestines. And one last time she ignored the warning signs. "I stayed there for five nights. I was ready to get out. I felt stronger and I knew what was going on with my body. It pissed me off when people would be like, 'you have to say here longer.'" Lindsay returned home, though in a few months she'd be back.

***

June, 2008, and Lindsay has been invited to a high school fashion show dedicated in her honor. "You've got to turn your wrist around," says Judith, as the pair get ready to walk out to the car. "Is that the one that isn't working?" On top of a pile of folded laundry in the kitchen sits Lindsay's newest pair of arms, $30,000 worth of custom workmanship the insurance company has approved on the third try. Unlike her first arms, which featured a metal clasp, these new arms have closing hands and fingers that are supposed to appear more lifelike. But with the added electronic sensors come more frequent malfunctions. And, more significantly, the suction required to keep them in place—a rubber sleeve tightly covers the residual limb—is often painful in hot and humid Richmond.

"Ready?" asks Judith. "Ready as I'll ever be," comes the response.

The two make the familiar trek to the car, past Sadie, through the back of the house, but this time no one is being pushed. Lindsay's been walking for two months now. As they make their way, Lindsay's right hand dangles slightly askew, but close enough. What's more noticeable is that there is no lift into a car this time around. Lindsay slides into the front seat by herself.

We're looking for the Maggie L. Walker Governor's School, and there's nothing quite like being in a car with a mother and daughter who are late. "Mom, you took the wrong exit," Lindsay chides, confessing to being a bad backseat driver. "Look right! Now go!"

"I'm all confused now, Lu," Judith sighs.

"Well, I didn't get you confused. We're really late." We turn down a dead end.

They finally arrive at the school. As Judith pulls in, Lindsay jokes that handicapped parking is by far the best part of losing one's arms and legs. Waiting by the school entrance is Lindsay's longtime mentor, Karen Videtic, chair of the VCU Department of Fashion Merchandising. They hug warmly. As the three women enter the school, a woman sitting behind a sign-in desk looks at Lindsay, a fleeting stare and then a quick turn of the head downward. Lindsay gets this kind of look a lot, the I'm-not-sure-how-to-react stare. "Do you need an elevator?"

Lindsay flashes that disarming smile. "An elevator would be good."

The three women take their seats in the first row. "The Fashion Merchandising Seminar kindly asks you make a donation to Love of Lindsay, a financial assistance organization that has been set up to alleviate the monetary burden that has been placed upon Lindsay and her family," the program reads. It gives a short recap of Lindsay's ordeal. Severe complications. Total organ failure. Quadruple amputee. Lindsay doesn't need to be reminded; she beams at the edge of the stage as the students reprise the history of fashion through the decades. This was the summer fashion class she was supposed to teach after graduation, before everything came unhinged. And though she's back today as an observer and not a teacher, she's clearly happy to be back at all.

Ironically, her story is beginning to parallel that of another young graduate of a Virginia university. In 2002, Virginia Tech freshman basketball standout Rayna DuBose contracted meningococcal meningitis, a severe bacterial infection. After ninety-seven days at the University of Virginia Medical Center, doctors had no choice but to amputate all four of her limbs. Her collegiate career would last only thirteen games.

Currently a motivational speaker, DuBose's website alludes to the unique challenges she shares with Lindsay. "Everyday I sit around and listen to other people complain about small things: writing a paper, their boss yelling at them, or parking spaces," Dubose writes. "The only thing I can do is listen, because I am simply thinking about how I am going to improvise to put these studded earrings in my ears, or how I can find a away to get my gas cap off to pump my gas, or maybe even how I am going to slip into my legs in the morning when I wake up."

Around the same time Lindsay Ess was entering the hospital in 2007 for her fateful procedure, DuBose was finishing the degree at Virginia Tech she had started five years earlier. More importantly, by the summer of 2003, only one year after her quadruple amputations, Rayna DuBose was back on a hardwood court, teaching at basketball camps. Her need to stay connected—quickly—to that which she loved is mirrored in Lindsay's desire to be at today's fashion show. And as she receives hugs from the students she would have taught, there's a palpable feeling of triumph.

But like everything in Lindsay's world, highs are often followed quickly by lows. On the way back from the show, she's suffering. The heat and the weight of her arms is too much. Judith stops at a traffic signal in front of Moore Baptist Church on Leigh Street and quickly pulls her daughter's prosthetics off. The sweatiness and soreness is unbearable—"the heaviness on my bones," Lindsay moans in pain—and the limbs vanish before the light turns green.

We duck into a T.G.I.Friday's and Lindsay orders a shot of tawaka liquor. The young waiter hasn't a clue what tawaka is, so Lindsay, a former bartender, explains not only what but where exactly it can be found in the bar. A colorful pile of pills is deposited by mom on top of an equally colorful Friday's menu. Probably not the exact combination the doctor would prescribe, but then again this isn't some clinical trial. Lindsay and Judith argue over whether Friday's is descended from Houlihans or the other way around. The debate unresolved, the pair comically moves on to the difference between saw mill and country gravy.

Lindsay's a tad angry. Not Bobby Knight angry, just teacher angry. It's the summer of 2008 and she's teaching another seminar, this time for high school seniors contemplating careers in fashion. Lindsay's wearing her legs this afternoon, but the arms are back home. Too painful in the summer.

"As soon as you are done exiting the stage, before the finale, stay over there," she says to her students, gesturing with her residual limbs. "If you exit the stage this way, you go behind the white curtain, silently and without touching the white curtain. Walk behind it. So now everybody try that. Do not touch it, do not talk." High heels click en masse on the stage. "Don't touch the curtain! Nuh-uh. You're touching it!"

The class huddles in a corner of the stage as Lindsay gives a pep talk. The only boy in the class makes a lame joke about someone talking like they have Tourette's Syndrome and Lindsay's head whips around. "Hey, none of that. We don't make fun of people." She commands everyone's attention now.

"Wear your heels day and night, through the dorms, up the stairs. They should be part of your own body, like your own feet." She shows the models how to stand. "This is not squaring your shoulders. This is squaring your shoulders." Finally, one last piece of advice: "Think happy thoughts."

During a break, Lindsay spots a ring on a fellow student teacher and asks excitedly, "Is that an engagement ring, Sian?" Sian smiles and returns the favor: "Is that an engagement ring on you? I hear you're getting married." Lindsay laughs. "Oh, I can't wear an engagement ring. Obviously."

With her youth, approachability and knowledge, it's easy to see why Lindsay is so beloved around campus. "I wouldn't have hired her if I didn't think she could do the job," Karen Videtic, the VCU fashion chair says. "People think, oh, she's only been out of school for a couple of years. She was a natural choice to teach the class. And to give Lindsay the opportunity, when a lot of her other opportunities, doors have been closed for her."

But it's not just opportunity. Lindsay's newfound body image is a plus in an age where too-thin models are finally being called out. "It's sort of an irony, isn't it?" Videtic asks. "I can see some of these models on the stage. Lindsay and I have even talked about it. We'll go, 'Hey, she's way too thin. Someone needs to talk to her. She's lost her perspective.' And I think that's a great thing. She can see when someone has lost their perspective on how thin thin is and what beautiful is. And hopefully the models themselves turn around and look in a whole new way."

(Though it's clear the industry still has much ground to make up. The editor of Self magazine recently defended her decision to Photoshop a good thirty pounds off Kelly Clarkson, September's cover subject, explaining that the final digital mirage is "meant to inspire women to want to be their be best.")

After the rehearsal, the students take a group photo with Lindsay in the center. Role model, fashion model, who knows what to call it. But there is something unmistakable afoot. On the way home, mother and daughter stop to see her orthopedic surgeon. The doctor examines Lindsay's knee, the open wound still refusing to heal despite numerous skin grafts, and Lindsay recoils in pain, burying her face in her elbows. Yet a minute later, physician is being playfully berated by patient. "I have to tell you, Dr. Nordt, this is the thorn in my spine. It's keeping me from meeting my goals. You know I want to be on the cover of Gastroenterology Monthly someday." Everyone laughs.

***

Here's something Lindsay's not angry about:

August 3, 2007, the day she entered the hospital for her procedure, was a Friday. Lindsay had just painted her toes pink. August 5th, the day sepsis started taking control of her body, minute by minute, was a Sunday. Both mother and daughter are careful when talking about what exactly went wrong during Lindsay's surgery, citing confidentiality agreements and a collective desire to stay focused on the future. Except when they're talking about Sundays and hospitals, when they say nursing levels can be thinner than during the week (every minute is precious when sepsis begins to develop), the pair conspicuously avoids anything that resembles finger pointing.

"I sprung a leak," Lindsay says. "That's what the doctors told me."

The procedure to relieve the pain in Lindsay's abdomen, by removing a small piece of enflamed intestine, doesn't usually result in complications. According to Dr. Kenneth Brown, the Richmond surgeon who worked desperately to save Lindsay's when things went awry, and who now oversees the team of doctors she still sees for a host of issues, in only one or two percent of cases does something go wrong. "She had surgery, she had a complication, and she had a disastrous fallout from a complication."

Lindsay backs up even further, questioning whether her decision to chose laparoscopy, a procedure in which small incisions are made in the abdomen, including one for a tiny camera, is to blame. Whereas traditional open surgery would have meant cutting through her stomach muscles, laparoscopy promised a way to avoid that. Lindsay, hoping for a quick recovery so she could begin teaching, not to mention always keeping an eye on her six-pack abs, not surprisingly went with the less invasive route. (In fairness, Dr. Brown notes that most patients today are likely to chose the least invasive surgery, flat stomach or not.)

"So I chose laparoscopy and I ultimately think that was the demise."

The "demise" she's talking about began with a leak. The sutures reconnecting her intestines didn't hold and Lindsay's intestines began polluting her body with bacteria. The resulting infection led to a condition known as diffuse intravascular coagulation, or DIC. "DIC is sort of clotting gone wild," says Robert Montgomery, chief of transplant surgery at Johns Hopkins. "It's a condition that can be triggered by severe infection, among other things. The normal homeostatic mechanisms that control bleeding and clotting go awry and blood clots form in the small vessels and the tissue loses circulation. It can cause tissue loss on its own but is also a marker of a really sick patient and so is generally associated with a poor outcome." (Another doctor recalled that back in medical school, DIC was described as "death is certain.")

As white blood cells were rallying to fight the source of infection, the DIC began raging everywhere else, erroneously sending signals of rampant bleeding, and, in turn, creating rampant clots. By the time doctors could respond, the situation had advanced to a critical point. Organs were failing and Lindsay suffered a brain seizure. She was put into a coma.

"I think that in every situation like this, especially where I'm somebody's daughter, I'm somebody's best friend, someone's fiancé, everyone hears a story and wants to blame somebody," Lindsay explains, choosing her words deliberately. "Personally, I like to keep my life very positive. At first, I won't lie to you, I wanted to blame somebody. But I'm passed that point. That was a millisecond of thought in my head. Possibly someone could say that there was someone to blame, yeah, obviously." After a pause she adds, "It's not my fault that it happened."

"It's a corporation," adds Judith.

It wasn't until October that Lindsay came to. "I woke up from the coma and looked down and I'm all bandaged. And I remember looking down straight from my bed and seeing my toes flesh colored and pink nail polish. And the rest going up was just black." Her limbs had lost all circulation due to the DIC and, not unlike a frostbitten climber on Mt. Everest, had turned jet black. "It's almost like she looked at the Medusa and turned to stone," Dr. Brown says. "The farthest away from the heart, the toes and the hands, those are affected the most."

At this point, Lindsay remembers simply trying to figure out how long she's been in the hospital, not whether her withered limbs can be salvaged. "I'm thinking, this is August 3rd" she says. "And right in front of me there's a calendar. I didn't know what date it was but I knew it wasn't August. Totally missed August. Totally missed September. Early October..." That's when a nurse spilled the beans. "Oh, honey, you know what they're going to do, right?" she remembers her saying.

Dr. Brown, who unabashedly acknowledges to having his life changed by being in Lindsay's company, remembers the amputation day vividly. "Some of these guys that I've practiced with for twenty, twenty-five years could not walk into the room because they were devastated. They weren't able to deal with their own reaction of what happened to her. But Lindsay had no problem at all. This was just one more hurdle she was going to jump over."

Lindsay's own memory seems to mesh. "I sat there for a few seconds," she says, "and thought about it, while the doctors were blah blah blah blah blah—you know, saying doctor stuff to me." As the specialists conferred with each other, the young woman helplessly connected to all those tubes and machines initiated her own internal dialogue. "I just sort of planned in my head what I was going to do, how things were going to change. You sit in the hospital and you have like sixteen channels to watch. And all you can do is plan your life. Get over it."

And then she said these words, without anger: "Let's just get on with it."

***

Photo by Matt Mendelsohn

Back to angry Lindsay. Well, sort of. She's peeved that a young kid is asking for money in the parking lot of Hanger. He probably figured that two women constituted an easy target. Mistake number one.

Just about every city in America has a Hanger office, though unless you've lost an arm or leg you may not have noticed. Hanger Prosthetics and Orthotics is one of the country's leading provider of care centers for people with artificial limbs. Amputees tend to spend a lot of time in their local Hanger office, tweaking the shape and fit of various prosthetics, which will often change with the patient's individual progress and need. After her amputations, Lindsay was airlifted to a hospital in Baltimore for recovery. Groggy and disoriented, she received a visit from Rayna Dubose, the Virginia Tech basketball player who had also lost four limbs. "I had never seen a prosthetic before I received mine," DuBose says, "but I was just excited, 'cause it meant one step closer to me getting my life back." Like DuBose, Lindsay will quickly learn the nuances of custom limb production, which starts with a quick-drying plaster mold and ends with a brand new arm.

While it's normal for most patients to receive this kind of treatment inside their local Hanger office, Lindsay doesn't do normal very well. And so it's not a surprise to hear that she once held a clinic of her own, outside in the parking lot, right there at the intersection of Belvedere and Grace.

She and her mom were pulling into Hanger one day when they noticed a teenager pulling a rolling suitcase. Too young to be homeless, they thought; walking too lethargically to be a student. The boy's knuckles are bandaged. "He was kind of slumped, but not slumped like he was drunk," says Lindsay. "Looking down—like an ashamed kind of looking down."

The young man approaches the car and asks for money. Judith reaches for her bag. "Wait, wait, wait, wait," Lindsay yells at her mother. She has questions. "I've always wanted to know," she explains later. "Wanted to understand why people give up on things. Give up on their lives, live on the street. I just don't get it." So the grilling begins, clearly more than the dollar the boy was hoping for.

"Do you live around here?" The boy says no and explains he's just been kicked out of a youth home. "Why? I was fighting. "Where's your mom?" In northern Virginia. "Why aren't you with her?" She's on probation. "Are you on drugs?" No.

I ask Lindsay if the boy notices anything odd about the young woman lecturing him. "No idea. He's not looking beyond his own nose." And with that, she goes from check to checkmate.

"Hey, look at me!" Lindsay yells. "I don't have any arms and I don't have any legs. And I haven't given up hope and I still believe in myself. I don't understand why you've given up." She pauses. "Do you believe in yourself? The boy nods unconvincingly. "Then say it!" The boy says I believe in myself. "Do you believe in yourself that you can achieve greatness?" Repeat the question, he says. Lindsay has him against the ropes. "Look up! Say it. I believe in myself! Hold your head up!"

"I believe in myself. I can achieve greatness." Again, Lindsay orders."I believe in myself. I can achieve greatness." Again."I believe in myself. I can achieve greatness." Again."I believe in myself. I can achieve greatness." Again."I believe in myself. I can achieve greatness." Again!"I believe in myself. I can achieve greatness." Again!

Damn, Lindsay thinks, I really can do this. She and her mother instruct the boy to go to another shelter, the Daily Planet, conveniently located directly right across the street from Hanger. "When you walk in, what are you going to say?" she asks him. I want a job? "Good, good."

As he walks away, Lindsay notices the boy's hat. "Hey," she calls out. "The Redskins will do better next year." The boy smiles for the first time. Lindsay retreats into the Hanger office, and, watching through the window as the boy crosses the street, dissolves into a pool of tears.

Depression

February, 2009 is a particularly cruel month to Lindsay. The Internet is filled with remembrances of Brazilian model Mariana Bridi da Costa, 20, that country's Miss World entry. A urinary tract infection had led to sepsis. And like Lindsay, the sepsis had cut the blood flow to the young woman's extremities, leaving doctors no choice but to amputate all four limbs. Unlike Lindsay, the young woman didn't make it through the night.

In Richmond, things should be looking up. Lindsay's moved out of her mom's place and into a hip, loft—style apartment with a pool right beneath her window. Though Judith is still there in the morning to get her out of bed, in the evening to put her to sleep, and in the middle to drive her where she needs to go-let's just say that Judith is never far away—Lindsay, a year and a half after losing all of her limbs, is now living on her own. Yet the mood is grim.

Lindsay is sitting on he bed and thinking she needs to throw up. Using the tip of her residual limb to maneuver the track pad of her computer, a skill that is remarkable to watch, she finds the number for a teacher at school, dials it on her cellphone and explains that she'll miss the first of her two classes this morning.

"What's causing this?" she groans to her mom. "Maybe you have a little something," Judith says. "What do you want?"

"Maybe a bucket. Mom, hurry! Trash can!"

The nausea isn't the only problem. A few feet from her bed, Lindsay's prosthetic arms and legs are stuffed forlornly among the clothes and shoes of a shelf unit. They look like they haven't been used in a while. It's the knee again. The skin graft on Lindsay's right knee has reopened yet again, exposing a painful wound.

After a shower, Lindsay feels well enough to go to her second class. As her mother applies medication to the sore on her kneecap, Lindsay looks down at the empty pool that sits below her window and laments that she doesn't think she'll ever feel comfortable enough to use it. Like the dress form, it's still all in the presentation.

Over at VCU, her students file into class and Lindsay chats with Whitney Stevens, a senior fashion merchandising major. "Look how big my knee is," she says. "It's from my legs. It's like three times the size. I just can't wear anything 'cause it's so swollen." And then, changing the subject: "Did you got church last night?"

After class is over, some of the students talk about Lindsay, as both a teacher and a role model. She's "a lot more direct," says Stevens. "With Lindsay, having done the show for thee years, she really knows what she's doing. I don't like somebody who just feeds me what I want to hear, or says, 'Oh that looks great.' She's going to tell you if it looks bad."

"We've been going to the same church," Stevens continues. "The first time I went, I saw her there. You can't help but cry when you hear the story and how she's still doing what she loves in the best way she can."

Another student, Clover Smith, interrupts. "Can I say something?" At thirty-five, Smith is older than her classmates. She's a full-time commercial banker and is going to VCU on the side. Smith explains to the class that her 5-year-old daughter died suddenly in an accident, a tragedy which she says gives her unique insight into her professor. "I'm just getting to know who she is, having gone through a tragic experience myself, losing my child, and seeing that Lindsay fights back. She's a strong individual. She wants to be here, she's happy. She makes the best of the situation she's been dealt with. It gives me another sense of enlightenment when I see her, the strength to move on."

The class is quiet, a few eyes welling with tears. Smith continues. "Every day is a struggle for me, facing every day corporate issues. You want to give up. You want to say this is stressing me out. I meet a lot of people every single day that let the superficial stuff get to them."

Ten minutes ago this class was discussing how long a fashion runway should be.

***

A few days later, I'm in Las Vegas attending a photography conference and my cell phone vibrates. "Have you seen Lindsay's Facebook status?!?!?!" the text message reads. It's my make-up artist friend Kim. In the darkness of the ballroom, as a slideshow about Brazilian cowboys rolls on the screen, I fumble with my iPhone's web browser until I reach the page. Like Kim, I gasp for a brief second. It says, simply, "Lindsay Ess is...expecting."

Two days later I check the page again. It reads, "Lindsay Ess is...mourning."

Denial

Photo by Matt Mendelsohn

May, 2009, the night before the big student fashion show and Lindsay is baffled. Her insurance company has now denied her high-tech arms, even though they'd been previously approved and even though she's had the custom-made prosthetics for over a year now. "They're denying everything but the hand," she says incredulously. "Which is ridiculous, because you can't do anything without the hand. After this semester, I'm just going to give them back," Lindsay says.

"It doesn't work that way," her mother Judith explains.

"Yeah, it does. If they're not going to pay for them, I'm not going to pay for them."

"They're not paying Hanger for them," Judith replies. "Hanger can't do anything with them after they've made them for you. It's Hanger that's gonna get screwed."

Judith helps Lindsay to get ready for the final dress rehearsal. "You look good," Judith says, and Lindsay snaps a bit. "Well, I have to think so, don't you understand that?" Back where we started. Those little jabs have always underscored a larger issue and tonight is no different. Lindsay is preoccupied with something that has less to do with fashion show production than presentation: a couple of girlfriends have asked her to go with them to a club after tomorrow's show. "It's a meat market," Lindsay says, unsure she's up to the task.

Much later that night, with less than 24 hours to show time, Lindsay is sitting at a table at 3 Monkeys, a neighborhood restaurant where she once tended bar. She's surrounded by three of her girlfriends, Bridget Fitzpatrick, Molly Dickerson, and our waitress, Amber Bohn, all of whom are thrilled to see Lindsay out and about . It's nearly impossible to hear anything, as the Chicago Bulls and Boston Celtics are battling it out in an epic triple-overtime playoff game. Because of the noise, Judith, sitting at the other end of the table, is pretty much left out of the conversation. It doesn't seem to bother her one bit. "It would be better for her if her mother isn't always hanging around," she tells me later. "I'm not waiting for any kind of recognition. I don't care about that shit. I'm just waiting for her to reclaim some of herself. Some of her ability to do things without me."

The girls help Lindsay take drags on a cigarette, which concerns her, though not for the obvious reason. She's worried that her grandmother will see the photo published someday. As the basketball game reaches the first overtime, the conversation takes a philosophical turn, one at distinct odds with the mood in the bar. After all, the four women are talking about the things most people tend to avoid during a hoops thriller: health care reform, pregnancy, absent men and lost children. Bridget says she doesn't want to get married just to have kids. "I want to have kids with Kevin, but I don't know if I want to marry him," Lindsay jokes back. At least it sounds like a joke.

"God implanted a child into me," she continues. "I was going to name him Malachi, which means the messenger of God. I really strongly felt that that it was God's way of telling me you're okay. Everyone is listening and talking at elevated levels now because of the noise in the restaurant. "You're strong enough to carry a baby, so you're strong enough to produce, you're strong enough to do what I put you on earth for. So in a sense it made me feel better. Losing it made me feel 10 times worse."

"It made me feel like I was human again, rather than so disabled. I was able to have what God puts you on the earth for."

"That's my number one goal in life," she yells above the cheering. "To have a child and raise him with the ideals that my mom has influenced." Tears begin welling up in Molly's eyes. "God saved me because I'm destined to have a child who will be such an awesome human being. He or she can see his mother and his father going through different issues in their life and still prevailing. It felt like it was my opportunity to give back to God."

And what will she tell her daughter about body image someday? "I'm going to tell her what my mom told me: pretty is as pretty does."

Bargaining

Because in the end, it's all a bargain. Acceptance might work for death but it's a real downer if you're trying to live. Accept what, exactly? That you can't drive or water ski or tie your shoelaces? Lindsay plans on doing all three someday. And so we bargain. We bargain with our doctors, we bargain with our mother (it's a Yin Yang thing, Judith says), we bargain with our boyfriends and, mostly, we bargain with ourselves. I'll start my diet tomorrow, after this last ice cream sundae. If I get out of this lie, I'll never cheat again. Don't let me die in this hospital, God. Episodes of House have neatly packaged endings. For everyone else, just an endless series of bargains.

"What's fashion to me anymore?" Lindsay asked recently. "It's not what your markup is in your store. It's not what price point you have for these sunglasses. It's about having faith in yourself and being happy with who you are." As she says this, you can't help but notice she's not wearing her arms very much anymore. She's found a comfort level and it doesn't involve acrylic. Rayna DuBose, the Tech basketball player, told me recently that she rarely wears her left arm or either of her two legs around the house. Lindsay seems to be following suit.

"In March, I needed to travel with an IV tube 24/7 due to an infection in my knee joint," she wrote in an email. "I really wanted to fulfill my obligation to my students, so I had to teach with no prosthetics (and a IV pumping out of my sleeve). This forced me to show who I am without them. Fortunately attitudes toward me hadn't changed, so mine didn't either. I am learning how to be efficient in doing things with and without prosthetics."

Lindsay understands these kind of bargains better than most. She knows all too well that Kevin, her fiancé, lives halfway across the country. But watching them at the pool one afternoon this summer, it's clear they savor their time together. Lindsay desperately wants to go in but she also can't get her knee wet; the open wound has finally begun to heal, once and for all. Kevin says it's too risky but those are fighting words to someone like Lindsay. Like a surveyor, she scopes out the possibilities and within five minutes she has Kevin picking her up and depositing her onto the pool's stairs, a compromise that allows her to wade and yet keep her knee above the water line. "She's been the most loyal companion that I've ever had," he tells me.

The bargain says that without a master's degree, the teaching gig might have run its course at VCU. Maybe I'll get my master's, Lindsay says. (She can always go back to tending bar at 3 Monkeys, Judith says, the two laughing. "They said that job is always open.") The bargain says that even though Lindsay has ultimately embraced the pool downstairs, the same pool she once vowed she'd never use, she's still unsure about tonight's girls outing to the bar after the fashion show. "Social anxiety," she says in the car. It says that the folks at Duke think she might be a candidate for a rare hand transplant, though Lindsay is thinking that maybe she feels more like herself without any prosthetics at all. It says that even though she's lost a child once, she can't wait to try again. These days, she's liking the name Siena for a girl.

The bargain even says that for all the progress you make, the downward stares are always there, and in many forms. I email Lindsay to say that the publisher of a large newspaper—where this story was to have run—has, based upon a three-sentence synopsis, deemed her story "depressing," certain to further the exodus of precious advertisers from the Sunday magazine. Advertisers want happier stories, the publisher explains.

Photo by Matt Mendelsohn

"WTF?!? How rude," comes Lindsay's emailed response, though like a lot of younger adults she's probably not reading too much print anyway. Gastroenterology Monthly be damned; Lindsay wants to be on television and a recent Facebook status declares her intent: "I want to be the star of my own reality series."

Dr. Brown is more to the point. "The human spirit, especially a young spirit, can't be beat by anything. You can't tell someone to sit down who does want to sit down. Simple as that. My interaction with Lindsay Ess makes me a better surgeon. I'm a better doctor today than I was two years ago. Interacting with her has taught me so much about what spirit is and what we're made of as human beings."

***

Since I'm asking so nice
Would you just entertain?
There's nothing left to hide you away
just show a little bit of brain.

The Bird and the Bee have sung, the models have strutted, and the fashions are a huge success. The 2009 VCU annual juried fashion show is over. At a cocktail reception, Lindsay revels in the well wishes, though she ultimately decides not to go downtown with the girls to the meat market bar. The bargain loves split decisions. As the elevator takes them down to the first level of the commons, where students are still lounging around, Judith asks her daughter if she's proud of herself. She's talking about the just completed show. "I guess so," Lindsay says.

(I believe in myself. I can achieve greatness.)

Outside, not a soul is stirring. Lindsay waits by herself in her chair for the car, illuminated only by an overhead streetlight. Judith pulls up and runs out, but before she can do her patented lift, the wheelchair hits a bump and Lindsay is almost knocked to the ground. "Mom! Be careful!!!"

"I'm sorry, Lindsay."

"Well, sorry doesn't count when it's the ninth time," and with that the mother and daughter disappear into the Richmond night.

Read a Q & A with Matt about this story: http://www.sportsshooter.com/news/2267

(Matt Mendelsohn is a freelance journalist based in the Washington D.C. area. He is a former staff photographer with UPI and served as the director of photography for USA WEEKEND. You can see his work at his personal website: http://www.mattmendelsohn.com/ and you can read his blog at: http://www.mattmendelsohn.net.)